How tax season helped boost health exchange enrollment in Tennessee

Tennessee basically doubled its Obamacare enrollment numbers during the last month and a half of Obamacare's open enrollment period, finishing the six-month process ranked No. 15 as a state in terms of number of residents who've selected a plan.

"I think Tennessee confirms the general trend," said George Brandes, director of health care programs for Jackson Hewitt.

The state's late surge is reflective of the national trend toward late-stage enrollment, Brandes said, especially notable in states using the federal marketplace rather than operating their own. Nationally, more than 50 percent of enrollees selected a plan between March 2 and April 19, the extended deadline for those who tried to select a plan earlier but were unable to due to technical difficulties.

Although state-based marketplaces also saw increases during the last month of open enrollment, Brandes said, their late-stage enrollees represented about 38 percent of their totals. In part, he said, that's because some state exchanges did not face the glitches the federal website did last fall, leaving more enrollees on the front end to outweigh those on the later end.

"But there aren't that many of those state," Brandes added. "Lots of the state-based exchanges never got off the ground."

According to Jackson Hewitt's research, Brandes said, the most likely explanation is the timing of tax refund distribution, the "largest liquidity injection" of the year for people in low- and middle-income bands who might not be able to consider purchasing health insurance until that money is in their hands.

That could spell trouble for next year's Obamacare open enrollment period, he added, which ends Feb. 15, only about two weeks into the time frame when people start receiving tax refunds.

That could make it tough for the administration to see robust enrollment numbers in next year's open enrollment period, he said, although if anything's been proven this time around it's that deadlines are not concrete when it comes to the early stages of the Affordable Care Act.

The tax season issue isn't the only one that may hamper the exchanges the second time around, either, however. This Bloomberg article note several others, including general functionality, customer service and Spanish-language outreach.